Fillable Compensation-Request-Form-for-Faculty - COMPENSATION REQUEST FORM FOR FACULTY

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Compensation-Request-Form-for-Faculty - COMPENSATION REQUEST FORM FOR FACULTY

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PASADENA AREA COMMUNITY COLLEGE DISTRICT
Human Resources
COMPENSATION REQUEST FORM FOR FACULTY
Name ______________________________________________ Date ____________________
Social Security Number ____________________________________________________
(REQUIRED)
Amount of compensation $____________________________
(Proof of available budget or transfer documentation must be attached.)
Effective dates of compensation: From _______________ To __________________
Please provide a brief description (do not use abbreviations) of the work to be performed by the instructor:
Labor Distribution: (To which account do we charge this assignment? Please make sure to list all 14 digits.)
__________________________________________ EMP: _______________________ (REQUIRED)
Cost Center Number
__________________________________________ EMP: _______________________ (REQUIRED)
Cost Center Name
Approvals:
___________________________________ __________________________
Cost Center Manager/Authorized Signature Date
___________________________________ __________________________
Appropriate Area Vice President Date
HUMAN RESOURCES USE ONLY
Board Report Number______________ PC# ___________________
Board Report Date_________________ Retirement Code and Date_______________
Job # __________________
Notes:
____________________________________________________________________________________
Lc012/11 revised
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Compensation-Request-Form-for-Faculty - COMPENSATION REQUEST FORM FOR FACULTY

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Completed 7 February 2020

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